A major cause of maternal mortality is barely mentionable in Tanzania: abortion. Illegal unless necessary to save a woman's life, nobody knows how significant a factor it is. The government believes that up to 30% of beds on obstetric wards are taken by women who have had unsafe abortions.

Any estimate is likely to mask the true figure, as many women in rural areas never reach hospitals and post-mortems are often not carried out. Post-abortion care reduces the risk of death, but only 5% of health facilities provide such services.

Marie Stopes Tanzania (MST) provides such emergency treatment for up to 3,500 women a year. Dr Leopold Tibye is a doctor in MST's clinic in Dar es Salaam and has seen the impact of illegal abortion first-hand. Many of his patients are teenagers. Most initially refuse to admit to having an abortion. All are offered advice on family planning, but such is the stigma for the unmarried with being seen in a family planning clinic that few follow up on it.

Dr Tibye has also worked in Tanzania's remote rural areas. He witnessed the desperate plight of women who had perforated their uterus with a bicycle spoke or who had severe infections after forcing cassava roots into their cervix.

"Sometimes there is no transport to take them to hospital in the first place, or there are no facilities there so they are told to go to the regional hospital. But that might be 1,200km away. Some die on the way or they just go home and die there."